Martínez-Valls Pablo Luis Guzmán, Honrubia Vilchez Beatriz, Rodríguez Tardido Almudena, Izquierdo Morejón Emilio, Pietricica Bogdan-Nicolau, Rosino Sanchez Antonio, Hita Villaplana Gregorio, Romero Hoyuela Antonio, Minaña López Bernardino
Servicio de Urología, Hospital General Universitario Morales Meseguer, Murcia, España.
Arch Esp Urol. 2008 Sep;61(7):781-5.
The presence of intravesical foreign bodies is exceptional; it is not a common emergency. Most foreign bodies have a sexual-erotic origin, although we cannot forget others such as elements left by the surgeon in the surgical field. We performed a bibliographic review on the topic.
We performed a PubMed (MEDLINE) electronic bibliographic search with the mesh terms "foreign-body migration" [MESH] AND "Urinary Bladder" [MESH] and bibliographic citations. We performed a bibliographic review establishing a classification depending on the origin and diagnosis, as well as treatment. Most publications are case reports. We described the most frequent presentation which was the same than we have in our Center.
We found a total of 122 works, nine of which were reviews; we selected 20 works. Although most are case reports, the reviews establish a classification depending on the origin: so, they refer to those foreign bodies directly introduced into the bladder: 1. By the patient: hairpins, safety pins, pencils, copper wires, hairs; 2. Accidentally: bullets; 3. Iatrogenic: fragments of bladder or ureteral catheters, staples, sutures. Foreign bodies migrated from other places: urological, gynecological, gastrointestinal, or vascular origin. We established a diagnostic and therapeutic algorithm.
Bladder foreign bodies are not as frequent as it is believed. Most are found incidentally. Lower urinary tract symptoms are the most frequent, as the antecedent of manipulation by the patient or others in the genital-urologic sphere. The treatment of choice is extraction using the least invasive and most simple method for the patient.
膀胱内异物的存在极为罕见,并非常见的急症。大多数异物具有性-情色起源,不过我们也不能忽视其他类型,比如外科医生遗留在手术区域的物品。我们对该主题进行了文献综述。
我们使用医学主题词“异物迁移”[医学主题词]和“膀胱”[医学主题词]在PubMed(医学文献数据库)中进行了电子文献检索,并查阅了文献引用。我们进行了文献综述,根据异物的起源、诊断以及治疗方法建立了分类。大多数出版物为病例报告。我们描述了最常见的表现形式,这与我们中心所遇到的情况相同。
我们共找到122篇文献,其中9篇为综述;我们挑选了20篇文献。尽管大多数是病例报告,但综述根据起源建立了分类:因此,它们提及那些直接引入膀胱的异物:1. 患者自行引入:发夹、安全别针、铅笔、铜线、毛发;2. 意外引入:子弹;医疗源性:膀胱或输尿管导管碎片、吻合钉、缝线。从其他部位迁移而来的异物:源于泌尿外科、妇科、胃肠道或血管。我们建立了诊断和治疗算法。
膀胱异物并不像人们认为的那么常见。大多数是偶然发现的。下尿路症状最为常见,是患者或其他人在生殖-泌尿系统进行操作的既往史。治疗的选择是采用对患者创伤最小且最简单的方法取出异物。